Written evidence submitted by United for All Ages [ASC 025]

1. United for All Ages is an intergenerational ‘think-do’ tank, bringing older and younger people together to improve care, health, housing and learning and reduce loneliness and ageism, thereby creating a Britain for all ages. Established in 2010, United for All Ages works with local and central government, the NHS, care and housing providers, schools, universities and a wide range of community organisations. In 2012 we launched Good Care Guide, a website where families can rate and review eldercare and childcare. We have worked with many care providers to develop intergenerational care. United for All Ages has commented frequently on the funding and delivery of care and ensuring that care reforms work for all generations. www.unitedforallages.com   

2. Rather than beginning with how care should be funded, we believe the starting point should be a new vision for care. No other public policy debate starts with how to pay for it - we must be clear about what we need first.
3. The vision has to start from where we are now and the failings of the current care system. The problems then point to five principles for a new system - it needs to be:

FAIR – moving from a lottery depending where you live to care you need whatever your circumstances

SIMPLE – moving from complex and confusing to simple and easy to use when and where you need care

PERSONAL – moving from one size fits all to care that starts from who you are and how you want to live

SUSTAINABLE – moving from growing unmet needs to well resourced quality care, managing demand

UNIVERSAL – moving from helping some people to helping everyone with their care needs

4. A new care system should be fair, simple, personal, sustainable and universal. To deliver this requires some key building blocks:

- a national framework for care and health that guarantees quality care for all across the country, with a single local body that commissions and delivers care

- a focus on prevention not just crisis care, managing demand and transforming the way care is delivered using technology, self-care and support for family carers, with a skilled and valued workforce

- a 10 year plan for making it happen for this and future generations

5. A cost-benefit analysis of this vision and plan for a new care system could provide the ammunition to secure investment from the Treasury in the next spending review. Reformed care and health are key parts of our social and economic infrastructure. They are crucial to the future of this country and the well-being of all families. Their economic contribution should be properly recognised for providing a growing number of jobs working in care and for supporting the whole workforce.
6. A tax-funded system is the fairest and most effective way to pay for joined up care and health and to share the risks and costs of care we may all face. It’s up to politicians to decide on the best way to raise the necessary tax revenue – from income tax on working adults or for example from a wealth tax on those who can most afford it. We would argue that taxation needs to be intergenerationally fair.
7. To achieve this vision, we need bold leadership. Leadership from the top of government – the Prime Minister, Chancellor and Secretary of State for Health and Social Care. Leadership from all the key partners and stakeholders in the care and health system. And leadership from all those who need better care – older and disabled people, their families and carers, and the care and health workforce. We must not duck this challenge.
8. Covid-19 has raised awareness of the fragility and underfunding of the current care system. It has highlighted the need for urgent and substantial reform, not more sticking plaster support. The response to Covid-19 has shown how investment by government can be mobilised swiftly and significantly where there’s a will. It has also highlighted the importance of prevention and planning for the future. Better lifelong housing for older and disabled people would reduce the demand for residential care. Covid-19 has also forced care providers to become more innovative and respond to the needs and wants of people using care.
9. The state of the adult social care market is symptomatic of the problems already highlighted above and by the National Audit Office’s recent report. Additional funding would help stabilise the market but it needs to be accompanied by a much more strategic approach by government nationally and by commissioners locally within a long term vision for care. This should address issues such as data and technology, outcomes and value for money, and workforce development.

April 2021